Summary & Overview
HCPCS A4380: Urinary Ostomy Pouch with Attached Faceplate, Rubber
HCPCS Level II code A4380 represents a rubber urinary ostomy pouch with an attached faceplate used for urostomy care. This durable medical supply is a common appliance for patients with urinary diversions following cystectomy, congenital anomalies, or other indications requiring an external urine collection system. Nationally, ostomy supplies like A4380 matter because they affect patient quality of life, ongoing home-care costs, and durable medical equipment coverage policies.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations, utilization benchmarks where available, coding context, and the clinical settings in which this device is typically used. The publication summarizes billing guidance, payer coverage patterns, and practical documentation elements relevant to claims involving A4380.
The report is intended for providers, billing professionals, and policy analysts seeking concise information on the code’s purpose, typical sites of service, payer scope, and areas where payers commonly apply clinical or documentation requirements. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code A4380 describes an ostomy pouch for urinary diversion with an attached faceplate, made of rubber. The service is the provision of a single urinary ostomy pouch device designed to collect urine from a urostomy and to fit over a stoma via an integrated faceplate.
Service type: Durable medical supply / ostomy appliance
Typical site of service: Home, outpatient clinic, or long-term care facility where ostomy supplies are used by patients with urinary diversions
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with a urinary diversion following cystectomy requires ongoing ostomy supplies. The ostomy pouch described (A4380: ostomy pouch, urinary, with faceplate attached, rubber, each) is dispensed to an adult patient who has a urostomy stoma and uses a one-piece rubber pouch with integrated faceplate. Typical workflow: a urologist or wound ostomy nurse performs the initial evaluation and documents the stoma type and supply needs. A prescription or plan of care is written specifying pouch type, frequency, and supply quantity. Durable medical equipment (DME) or ostomy supply provider dispenses the A4380 pouch in the home health, outpatient clinic, or DME supplier setting. The patient or caregiver is instructed on pouch application, skin care, emptying/drainage technique, and replacement schedule. Common clinical reasons for use include incontinent urinary diversion (e.g., ileal conduit), postoperative management after cystectomy, or long-term urostomy care for neurogenic bladder complications. Typical sites of service: home health, outpatient clinics, DME supplier, and inpatient discharge planning when converting to outpatient supplies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |